Alcalá M J, Casellas F, Fontanet G, Prieto L, Malagelada J-R
Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Inflamm Bowel Dis. 2004 Jul;10(4):383-91. doi: 10.1097/00054725-200407000-00009.
Questionnaires for measuring quality of life in patients with inflammatory bowel disease usually include a large number of items and are time-consuming for both administration and interpretation. Our aim was to elaborate and validate a short quality-of-life questionnaire with the most representative items from the Spanish version of the 36-item Inflammatory Bowel Disease Questionnaire (IBDQ-36) using the Rasch analysis. The responses to 311 IBDQ-36 questionnaires from 167 patients with ulcerative colitis (UC) and 144 with Crohn's disease (CD) were analyzed. IBDQ-36 was shortened with successive Rasch analyses until all the remaining items showed acceptable separation and goodness-of-fit properties. Validation of the short questionnaire was studied in a new group of 125 patients by determining its validity and reliability. A 9-item short questionnaire was obtained (IBDQ-9). Its correlation with IBDQ-36 was excellent (r = 0.91). Correlation between IBDQ-9 and clinical indices of activity was statistically significant in UC (r = 0.70) and CD (r= 0.70). IBDQ-9 score discriminates adequately between patients in clinical remission or relapse (P < 0.01). Sensitivity to change was determined in 14 patients who improved clinically, showing significant IBDQ-9 changes between both determinations (P < 0.01), with an effect size of -2.67 in UC and -5.29 in CD. IBDQ-9 was also homogeneous, with a Cronbach's alpha of 0.95 in UC and 0.91 in CD. In 35-clinically stable patients, test-retest reliability was good, with a statistically-significant correlation between both questionnaires (r = 0.76 in UC and 0.86 in CD, P < 0.01) and an intraclass correlation coefficient of 0.82 in UC and 0.84 in CD. In conclusion, a short and valid questionnaire to measure quality of life in patients with inflammatory bowel disease was obtained using a new measurement model. Its use should facilitate comprehension of the impact of inflammatory bowel disease.
用于测量炎症性肠病患者生活质量的问卷通常包含大量项目，管理和解读都很耗时。我们的目的是使用拉施分析，从36项炎症性肠病问卷（IBDQ - 36）的西班牙文版本中精心挑选出最具代表性的项目，编制并验证一份简短的生活质量问卷。分析了167例溃疡性结肠炎（UC）患者和144例克罗恩病（CD）患者对311份IBDQ - 36问卷的回答。通过连续的拉施分析对IBDQ - 36进行缩短，直到所有剩余项目都显示出可接受的区分度和拟合优度。通过确定其有效性和可靠性，在一组125名新患者中研究了简短问卷的有效性。获得了一份9项简短问卷（IBDQ - 9）。它与IBDQ - 36的相关性极佳（r = 0.91）。IBDQ - 9与UC（r = 0.70）和CD（r = 0.70）的临床活动指标之间的相关性具有统计学意义。IBDQ - 9评分能够充分区分临床缓解或复发的患者（P < 0.01）。在14例临床症状改善的患者中确定了对变化的敏感性，两次测定之间IBDQ - 9有显著变化（P < 0.01），UC中的效应大小为 - 2.67，CD中的效应大小为 - 5.29。IBDQ - 9也具有同质性，UC中的克朗巴哈系数为0.95，CD中的为0.91。在35例临床稳定的患者中，重测信度良好，两份问卷之间具有统计学意义的相关性（UC中r = 0.76，CD中r = 0.86，P < 0.01），UC中的组内相关系数为0.82，CD中的为0.84。总之，使用一种新的测量模型获得了一份简短且有效的问卷，用于测量炎症性肠病患者的生活质量。其使用应有助于理解炎症性肠病的影响。
